应用Toth水解剖技术显微手术治疗高血压壳核出血  

Water dissection technique of Toth for microsurgical treatment on hypertensive putaminal hemorrhage through transsylvian transinsular approach

作　　者：吴建东[1] 林荔清[1] 钱苏荣[1] 傅西安[1] 肖其华[1] 王晨秋[1] 王剑韧[1] 王晨[1] 惠国桢[2] 

机构地区：[1]南京医科大学附属苏州医院神经外科,苏州215008 [2]苏州大学附属第一医院神经外科

出　　处：《中华神经外科杂志》2010年第10期882-884,共3页Chinese Journal of Neurosurgery

摘　　要：目的 探讨高血压壳核出血的手术治疗方法和效果.方法 对经侧裂-岛叶入路应用Toth水解剖技术显微手术治疗的50例高血压壳核出血患者的临床资料进行回顾性总结分析.结果 术后第1天复查头颅CT示：血肿清除大于90%者41例,其余9例血肿清除小于80%.术后存活41例,死亡9例.存活的41例中,术后6个月根据GOS评分：恢复良好9例,中残13例,重残15例,植物生存2例,死亡2例.结论 经侧裂-岛叶入路应用Toth水解剖技术显微手术治疗高血压壳核出血对脑组织损伤小,血肿清除彻底、神经功能恢复好.Objective To study the method and effect of microsurgical treatment on patient with hypertensive putaminal hemorrhage through transsylvian transinsular approach. Method By means of water dissection technique of Toth with microsurgical treatment through transsylvian transinsular approach, the data of fifty patients with hypertensive putaminal hemorrhage were respectively analyzed. Result Heamatomas were evacuated for more than 90% in 41 cases, less than 80% in 9 cases in postoperative CT scanning 41 cases survived and 9 cases died after operation. The treatment effects in survived patients were evaluated at six months after operation. According to Glasgow Outcome Scale （GOS）： good recovery, moderate disability,severe disability, persistent vegetable state and death were in 9 cases, 13 cases, 15 cases, 2 cases and 2 cases respectively. Conclusion Water dissection technique of Toth with microsurgical treatment through transsylvian transinsular approach is effective for hype rtensive putaminal hemorrhage, and it is characterized by minimal cerebral tissue injury, high heamatoma remove ratio and good nervous function recovery.

关 键 词：颅内出血 高血压性 壳核出血 水解剖技术 显微外科手术 经侧裂-岛叶入路 

分 类 号：R686[医药卫生—骨科学]